Monday

Dec 21, 2009 at 12:01 AMDec 21, 2009 at 9:18 PM

Whatever you think of health care reform, it's galling to think that a single guy can hold up everything or fundamentally alter any bill's substance, as Joe Lieberman - the filibuster-proof 60th vote in the Senate - has with health care legislation. How in this democracy did we end up with government by a minority of one?

Whatever you think of health care reform, it's galling to think that a single guy can hold up everything or fundamentally alter any bill's substance, as Joe Lieberman - the filibuster-proof 60th vote in the Senate - has with health care legislation. How in this democracy did we end up with government by a minority of one?

Whether Lieberman, the independent from Connecticut who once aspired to be the Democratic vice president of the United States, is taking a principled stand or an unprincipled one may depend on what side of the health debate you are on, but he seems a bit too giddy about getting all this attention to suit our tastes, suggesting that this is all about Joe Lieberman rather than the tens of millions of Americans who are uninsured or underinsured, and the many more with insurance who are seeking relief from skyrocketing premiums and deductibles.

In any case, Lieberman's stance - and Nebraska Sen. Ben Nelson's since - has helped to produce a Senate bill that has achieved what heretofore we thought impossible, managing to alienate liberals and conservatives alike. Even former Democratic National Committee Chairman Howard Dean, himself a doctor, now says "kill the bill," calling it a diluted piece of primarily corporate welfare for the insurance and pharmaceutical industries that is "crafted to get votes, not to reform health care."

The Senate bill has evolved so much, so quickly that it has been difficult to keep up with. Indeed, on Saturday morning Senate leadership unveiled a 338-page list of last-minute amendments. We'd wager a fair number of senators will not know specifically what's in it even when they vote. And the White House wants passage by Christmas?

There is no public option for private-sector rejects, no Medicare buy-in at 55. But neither is there any provision for removing the barriers to interstate competition between insurance companies. There is no tort reform. Democrats claim it will provide coverage for up to 31 million Americans who don't have it now and end discrimination against pre-existing conditions while capping how much private insurers can charge them, though there are reports it could still be prohibitively expensive even with subsidies. Like the House, the Senate mandates coverage for all Americans, while fining those who don't comply. Young people could stay on their parents' health care plans until age 27. Medicare shrinks a little, Medicaid expands. Some states get special treatment, like Nebraska. For those expecting immediate changes, reportedly benefits are backloaded to 2014 - plenty of time for premiums to rise.

At this point we're not quite grasping how this will corral costs or widen choices for consumers, though let's face it, expanded coverage and reduced expense were mutually exclusive goals from the start. Some on both sides now feel it will be all but impossible for Barack Obama to keep his two big promises: one, that there will not be "a single dime" of tax increase for anyone earning under $250,000; and two, that those satisfied with their existing health coverage can keep it, as is.

Most Americans are dubious, with public opinion polls showing a majority who believe the bill will worsen the coverage they have now, hike their premiums, drive up deficits and raise their taxes. The estimated price tags have been so all over the map that we're not confident any of them are reliable. The latest Congressional Budget Office estimate is $871 billion over 10 years, compared to the House's $1.2 trillion version. It's a big gamble for Democrats who trust Americans will warm to this soup once they taste it. Of course, it's a risk for Republicans who've been a unified "no," too.

We're frustrated with all of them, from a President Obama who has called this his top domestic priority but hasn't acted like it, flying here, there and everywhere when he should have been in Washington attending to business; to Lieberman, who as others have observed appears to be a wholly owned subsidiary of the insurance industry, for anyone who cares to look up his political contributions; to other flip-floppers like Sen. John McCain, who was all for cutting a bloated Medicare when he was running for president but now finds it a sacrosanct, mean, lean, efficiency machine.

If there were a killer asteroid hurtling toward Earth, we firmly believe Democrats would lard their legislative remedy with earmarks while Republicans would loudly protest - it's a Democratic idea, after all - grab their share and insist the entirety of the bill be read aloud on the chamber floor, all while the precious minutes ticked away.

When Congressman Aaron Schock, R-Peoria, was in for a visit recently, he said that while a significant majority of his constituent feedback expressed opposition to the health care legislation now pending, almost to a person they wanted Uncle Sam to "do something" about a status quo that is serving precious few of them well. Is this that "something"?

This newspaper's position hasn't changed: Keep it simple, cover those uninsured through no fault of their own - pre-existing conditions, the suddenly jobless, their children - try to limit taxpayer exposure in an era of economic stagnation and knee-buckling deficits by not over-extending the safety net. If those folks get left on the side of the road again in a nation still as relatively wealthy as this one, arguably this will be not only a legislative failure but a moral one. We've heard assurances from centrists - Sen. Evan Bayh of Indiana, for one - that, while imperfect, this bill won't do that. Wish we could be as certain.

Even if the Senate concurs with Bayh, it's not a done deal, as the House gets another whack at it, with both chambers far from being on the same page. We'll see what emerges. What shouldn't is perhaps the worst case: after all the vote-counting compromises, a nothing law that pretends to be something, and costs a fortune besides. No one thought this would be easy or pretty, but in many ways it has gotten downright ugly.

Peoria Journal Star

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